The present invention relates generally to the treatment of esophageal varices, and more particularly to a method and apparatus for applying sclerosant or thrombosant agents to esophageal varices. Further, the present invention relates to a method for the destruction of mucosal neoplasms by positioning destructive therapeutic agents thereon.
A medical practitioner realizes that it is often necessary to medically treat the variceal veins within the esophagus. Currently, therapeutic techniques such as injection sclerotherapy and band ligation are utilized for the immediate and long term control of hemorrhaging associated with esophageal varices. Injection sclerotherapy involves positioning a long needle within an endoscope and injection various solutions directly into the esophagus. The second therapeutic technique, band ligation utilizes an endoscope to visualize the varix, suck the varix into a banding cap and then release a small rubber band that compresses the site. Both of these therapeutic techniques produce an inflammatory response within the esophageal mucosa that serves to thrombosis the varices and produce long lasting fibrosis in the mucosa that includes the variceal channels and prevents further bleeding.
A limitation common to the prior therapeutic techniques manifests itself in a patient with active bleeding, because active bleeding and associated blood clots cover and obscure the field of view, thereby rendering the procedure difficult to perform. Further, the large dilated esophageal varices fill the esophageal lumen and make it difficult to visualize individual varices or the anatomy, thereby requiring considerable expertise on the part of the practitioner.
Another limitation associated with the prior therapeutic techniques is the general requirement of multiple endoscopic procedures, generally three to six procedures, for the obliteration of varices in the esophagus. Localized trauma, which is a normal part of the prior therapeutic techniques may incite immediate bleeding or produce esophageal ulcers that frequency bleed during the intervals between treatments. Esophageal bleeding may have severe consequences and in certain situations may be life threatening. Further, each endoscopic procedure is expensive, requires that an anesthetic agent be administered to the patient, and is associated with some hazard as well as inconvenience to the patient.
Band ligation and injection sclerotherapy are viewed as being incomplete in the sense that they can not be performed in a uniform manner over the entire mucosa. Consequently, it is possible for a medical practitioner to omit areas and, therefore multiple procedures may be required to ensure that the entire mucosa surface is treated and that all varices are thrombosed and that the mucosa is destroyed. Therefore, the prior techniques may necessitate multiple follow-up examinations and long term surveillance to assure that the mucosa surface has been completely treated.
Although the prior techniques are steps in the right direction for the treatment of esophageal varices, the need for additional improvements still remain. The present invention satisfies this need in a novel and unobvious way.